California Democrats from neighboring districts part ways on health care

Reps. Doris Matsui and Ami Bera are both Democrats, represent parts of California’s Sacramento Valley and vote pretty much the same way on most issues.

But when it comes to the president’s health care law, they could be from different parties, even different regions of the state. The lawmakers both represent Sacramento County, which includes two congressional districts, each with a different balance of party registration.

Meanwhile, a poll this week shows a gap in support for the health care law between Democrats and Republicans in the state, in spite of the relatively trouble-free debut of California’s health insurance exchange, the portal for signing up for coverage under the law.

Matsui has worked on health care issues since she came to Congress in 2005. She voted for Affordable Care Act when it passed in 2010 and has remained an enthusiastic supporter. She has opposed Republican efforts to defund, delay or modify it.

“The changes have to be changes that don’t undermine the bill itself,” she said.

In California’s 6th Congressional District, which she represents and where registered Democrats outnumber Republicans 2-1, Matsui won re-election to a fifth term with 75 percent of the vote last year.

Bera’s neighboring 7th district is about evenly split between Democrats and Republicans. He defeated a veteran Republican last year with 51 percent of the vote in a year when President Barack Obama won California by 20 points.

A physician who wasn’t in Congress when the law was approved, Bera has criticized certain provisions and worked with Republicans to change it. Last month, he voted for a Republican proposal to allow more people to keep the health insurance plans they have, an idea that Obama also embraced. He has also co-sponsored a GOP measure to delay a tax on health insurance plans.

In his short time on Capitol Hill, Bera has formed personal friendships with many of his Republican colleagues and joined a bipartisan group of lawmakers called the Problem Solvers Caucus. Of the fractious debate over Obamacare, he doesn’t “take the approach that this is always going to be a battle.”

But Republicans won’t give Bera any credit for working with them to fix a health care law he ultimately supports. The GOP sends out regular emails tying him and other vulnerable Democrats to the president’s health care law.

“He’s been a consistent supporter,” said Daniel Scarpinato, a spokesman for the National Republican Congressional Committee, the House campaign arm of the Republican Party. “He may want to get off the Obamacare train, but it’s too late.”

A Public Policy Institute of California poll this week shows the state evenly split on the law, with a sharp difference between parties. The survey, taken a month after the Oct. 1 rollout of HealthCare.gov, the federal website for insurance enrollment, shows that 60 percent of Democrats viewed the law favorably, while 80 percent of Republicans viewed it unfavorably.

Jack Pitney, a political science professor at Claremont McKenna College in Claremont, Calif., said it makes sense for Bera to take a more skeptical approach on the issue.

“Matsui has a relatively safe seat,” he said. “Bera is going to have to work a lot harder to hold on.”

Not only does Bera have a sizable bloc of Republican voters in his district, he faces an election where fewer Democrats could turn out. Pitney said the party of the president in office almost always loses seats in midterm elections.

Without Obama on the ballot in 2010, many of his core supporters sat out the election, helping Republicans take over the House. Bera lost that year in his first attempt to unseat the then-incumbent, former Republican Rep. Dan Lungren.

Both Bera and Matusi said their perspectives on health care were shaped by their personal experience with it, the former as a physician and the latter as a lawmaker. They both support the law’s goal of expanding coverage, but part company on the next steps.

“We have to use every mechanism possible to make sure we get folks health insurance coverage that works for them, that meets them where they are,” Bera said. “Let’s get ahead of this.”

Matsui counsels patience.

“As thing goes along, I’m sure there’s going to be more bumps,” she said. “But we can’t lose focus on what we’re trying to do here.